泌尿生殖器疾患(とくに尿路性器癌)と血清Tissue Polypeptide Antigen (TPA)

Abstract

泌尿器悪性腫瘍患者189例, 泌尿器良性疾患患者260例, 健康人72例につき血清TPAをRIA法で測定した.1)泌尿器悪性腫瘍患者の血清TPA陽性率は, 未治療患者全体で73.5%, 遠隔転移患者9例中8例, 治療患者全体では33%であった.2)悪性腫瘍の再発, 再燃時には陽性化した.3)前立腺癌患者10例の経時的にみた血清TPAは治療効果, 再然と良く相関した.4)前立腺癌33例の前立腺性酸性フォスファターゼ(PAP)と血清TPAを同時に測定した.未治療例の陽性率は, PAP 50.0%で, 血清TPAは87.5%で, 再燃例は両者とも陽性であった.5)膀胱腫瘍48例の血清CEAとTPAを同時に測定した.未治療症例の陽性率はCEA 33.3%, TPA 77.8%で, 遠隔転移例では, CEA 50%, TPA 100%であった.6)泌尿器良性疾患, とくに尿閉や尿路感染を合併する例では, 血清TPAが一過性に陽性化した

We measured the serum TPA level in 260 patients with benign urogenital diseases, 189 patients with urogenital cancer and 72 healthy blood donors by using a radio-immunoassay kit in order to evaluate its usefulness as an indicator for the presence of cancer. TPA value (mean +/- 2SD) in healthy blood donors was in the range of 36.8-110.8 units per liter, so that values higher than 110 U/L were considered to be abnormal. Significantly higher serum TPA levels were observed in patients with non-treated cancers, compared to healthy blood donors. But elevated serum TPA levels were also observed in the patients with benign diseases, especially in cases of benign prostatic hyperplasia with urinary tract infection. Consequently, it is considered that the serum TPA test is very useful for detecting urogenital diseases, but not for screening urogenital cancer. In cases of urogenital cancer, serum TPA levels elevated significantly by recurrence or recrudescence of the disease. Therefore, a good correlation was established between serum TPA and the efficiency of a given therapy in patients with prostatic cancer and bladder cancer.